The 2004 Madrid train bombings: an analysis of pre-hospital management

The terrorist train bombings in Madrid, Spain, on 11 March 2004 triggered a swift and massive medical response. This paper analyses the pre-hospital response to the attacks to gain insight into current trends in disaster management among Madrid's Emergency Medical Services (EMSs). To this end, the existing emergency planning framework is described, the basic structures of the different EMSs are presented, and the attacks are briefly depicted before consideration is given to pre-hospital management. Finally, an explanation of the main underlying misconceptions in emergency planning and management in Madrid is provided to aid understanding of the origins of some of the problems detected during the response. These are attributable mainly to inappropriate planning rather than to mistakes in field-level decision-making. By contrast, many of the successes are attributable to individual initiatives by frontline medics who compensated for the lack of clear command by senior managers by making adaptive and flexible decisions.     

基于环境地理信息平台的预警系统的构建

随着经济的高速发展,环境污染事故也呈现出上升的势头,环境污染事故不仅造成了环境危害,而且对人民群众的安全产生了重大威胁。鉴于环境污染事故的多发性、危害性,应急处置显然非常重要,而构建强大的应急处置信息系统有助于应急处置和分析决策的顺利进行。本文分析了环境应急处置需求,提出了建立环境污染应急管理信息系统的设计框架。     

渔业污染事故的应急监测

简述我国渔业污染现状,分析突发性污染死鱼事件的管辖权问题和一般分类,提出突发性污染死鱼事件应急监测的实施和要求.     

Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.     

An easy method to design gas/vapor relief system with rupture disk

Tank discharge gas/vapor flow problems are frequently encountered in both practice and design. To perform this type of design calculation, the first step is to identify whether the flow is choked or not through a trial-and-error solution of an equation for adiabatic flow with friction from a reservoir through a pipe. Developing a direct method without any trial-and-error to identify a choking condition would be helpful for expediting the flow calculations. This paper presents an easy and quick method to identify the choking of gas flow for an emergency relief system consisting of a rupture disk and vent piping. This greatly simplifies the design calculations. The proposed method for validating the venting adequacy of existing ERS circumvents the iteration calculation and the use of Lapple charts. Three case studies for the design of vent piping for rupture disks support the proposed method.     

Attitudes of rural population in emergency exposure situations

People growing crops in kitchen gardens eat locally self-produced food and are the subject of growing attention as the potential for a more sustainable development. A survey was carried out in two provinces in northern Italy to gather information on the consumption of local horticultural products, peoples’ expectations of authorities in the case of a nuclear accident and peoples’ behaviour in the absence of official information. Results show that up to 70% of the owners of kitchen gardens possess diets comprised of more than 60% of self-produced vegetables and can be regarded as particular groups of population. In the case of a dispersion of radioactive material, the local population would take advantage of official information on preventive measures to protect farms and local crops from contamination. Results of the survey show differences in the attitude of the population due to age, gender and past experience.     

Earthquake Planning for Government Continuity

/ The problem of assuring government operational continuity following earthquakes has been given little research attention. Recent earthquake experience has documented that government organizations without a public safety mission do incur damaged facilities and routinely see increases in public demands following an earthquake. Impediments to service delivery associated with such dam-ages can be minimized if agencies address earthquake plan elements likely to enhance postimpact functioning, including: the potential to relocate operations, protection for the workplace, possession of an organizational inventory, emergency instructions for employees, the ability to use volunteers, and communication capacity. Factors associated with the adoption of these plan elements were studied in one county government and its municipal county seat in the southwestern United States. A census of departments within these jurisdictions was asked to complete a questionnaire reporting the level of planning activity relative to each of these plan elements. It was found that the overall level of preparedness was low, but statistically significantly related to agency size, perceived risk, and information seeking. The implications of these findings underscore the potential for disruption to government service delivery and permit the identification of potential avenues for increasing levels of preparedness.KEY WORDS: Emergency planning; Earthquakes; Government preparedness     

重大工业危险源(罐区)监控预警系统

系统建立了管理软件和硬件监控相结合的安全生产监控预警系统，在安全管理的基 础上，把罐区诸多的危险参数给予实时监测、报警和控制。本系统实现了生产过程控制与安全监控 相结合，安全监测报警与事故预案相结合，既满足了生产控制又实现了动态的安全管理，对安全生产 具有较大意义。     

A taxonomy of performance influencing factors for human reliability analysis of emergency tasks

This paper introduces the process for, and the result of, the selection of performance influencing factors (PIFs) for the use in human reliability analysis (HRA) of emergency tasks in nuclear power plants. The approach taken in this study largely consists of three steps. First, a full-set PIF system is constructed from the collection and review of existing PIF taxonomies. Secondly, PIF candidates are selected from the full-set PIF system, considering the major characteristics of emergency situations and the basic criteria of PIF for use in HRA. Finally, a set of PIFs is established by structuring representative PIFs and their detailed subitems from the candidates. As a result, a set of PIFs comprised of the 11 representative PIFs and 39 subitems was developed.     

Seat belt use in the ambulance patient compartment by emergency medical services professionals is low regardless of patient presence,seating position,or patient acuity

Background: Inconsistent use of seat belts in an ambulance may increase the risk of injury for emergency medical services (EMS) professionals and their patients. Our objectives were to: (1) describe the prevalence of seat belt usage based on patient acuity and seat location, and (2) assess the association between EMS-related characteristics and consistent use of a seat belt. Methods: We administered a cross-sectional electronic questionnaire to a random sample of 20,000 nationally-certified EMS professionals, measuring seat belt use in each seating location of an ambulance during transport of stable, critical, or no patients. We included practicing, non-military, emergency medical technicians or higher who reported working in ambulances. We used multivariable logistic regression models to estimate the odds of consistent (≥50% of the time) use of seat belts for the rear-facing jump seat and right-sided crew bench during transport of stable and critical patients. Results: A total of 1431 respondents were included in the analysis. Patient compartment seat belt use varied with the highest use in forward-facing seats when no patient was being transported (59.8%) and lowest use in the left-side “CPR” seat with a critical patient (9.4%). Only 40.2% of respondents reported an agency policy regarding seat belt use while riding in the patient compartment. In all multivariable logistic regression models, advanced life support level certification and fewer years of experience were associated with decreased odds of consistent seat belt use. An agency seat belt policy was strongly associated with increased odds of seat belt use in the patient compartment. Conclusions: Seat belt use was low and varied by seating location and patient acuity in the patient compartment of an ambulance. Practical Applications: EMS organizations should consider primary prevention approaches of provider education, improved ambulance designs, enactment and enforcement of policies to improve seat belt compliance and provider safety.